Individual
STEPHANIE R MCCAULEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2196 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-2708
(866) 389-2727
Mailing address
2196 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-2708
(866) 389-2727
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9662
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
387209200
—
MN
Enumeration date
02/24/2006
Last updated
11/29/2023
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